ALA-PDT combined with holmium laser therapy of postoperative recurrent extramammary Paget’s disease

•Postoperative recurrent extramammary Paget’s disease (EMPD) involving the vulva, scrotum, penis and perianal region of elderly individuals is challenging to treat.•A 71-year-old patient with postoperative recurrent perineal invasive EMPD was successfully treated with ALA-photodynamic therapy combined with holmium laser.•Skin ultrasonography is used to monitor the invasion depth of lesions for guidance of the treatment and assess the therapeutic efficacy.